CMS CODES

Remote Patient Monitoring

Remote monitoring of physiologic parameters (e.g., weight, blood pressure, pulse oximetry, respiratory flow rate), initial setup and patient education on the use of equipment.

Chronic Care Management

Chronic care management services, at least 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month.

Principal Care Management

Principal care management services, for a single high-risk disease, each additional 30 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month.

Behavioral Health Integration

Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a physician or other qualified health care professional, per calendar month.

Community Health Integration

Community health integration services performed by certified or trained auxiliary personnel, including a community health worker, under the direction of a physician or other practitioner; 60 minutes per calendar month, in activities to address social determinants of health (SDOH) needs that significantly limit the ability to diagnose or treat problems addressed in an initiating E/M visit.

Patient Illness Navigation

Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a patient navigator; 60 minutes per calendar month. This service is intended to help patients with serious conditions navigate their healthcare treatment.